锌硒合剂佐治儿童迁延性或慢性腹泻的疗效

摘要

目的 探讨微量元素锌、硒佐治儿童迁延性或慢性腹泻临床治疗效果.方法 将90例迁延性或慢性腹泻患儿随机分为治疗组、对照组,每组45例,对照组给予胃肠粘膜保护剂、微生态调节剂、补液及指导合理饮食等常规治疗;治疗组在常规治疗的基础上补充锌硒宝,分别测定两组患儿治疗初期血锌、血硒值,治疗前、治疗后随访期间测定两组患儿血清免疫球蛋白IgA、IgG、IgM和T细胞亚群水平,观察临床疗效,记录患儿腹泻复发次数.结果 治疗组与对照组患儿治疗初期血锌平均值均明显低于健康小儿(t值分别为4.28、4.47,均P<0.05);治疗组与对照组患儿治疗初期血硒平均值均明显低于健康小儿(t值分别为2.46、2.76,均P<0.05).治疗前,两组患儿IgA、IgG、IgM、CD3、CD4、CD8水平和CD4/CD8比值比较均无显著性差异(均P>0.05);治疗并随访3～6个月后,治疗组患儿IgA、IgG、CD3、CD4水平和CD4/CD8比值均明显高于对照组(t值分别为10.76、5.19、3.86、2.63、3.47,均P<0.05).在临床症状缓解时间、总疗程方面治疗组均短于对照组(t值分别为9.25、6.53,均P<0.05);治疗组与对照组总有效率分别为86.67%和66.67%,经比较有显著性差异(χ2=5.03,P<0.05),且1年内不同时期治疗组腹泻发作次数明显低于对照组(t值分别为10.91、4.65、3.72,均P<0.05).结论 儿童迁延性或慢性腹泻在常规治疗的基础上给予补锌补硒治疗,对缩短病程、缓解症状,增强小儿免疫功能,减少复发,提高远期疗效等均有良好的作用.%Objective To explore the clinical efficacy of auxiliary therapy with trace elements zinc and selenium on children with persistent or chronic diarrhea. Methods 90 children with persistent or chronic diarrhea were randomly divided into treatment group and control group,45 children in each group. The control group received conventional treatments including gastrointestinal mucosa protective agent, micro ecosystem regulator, fluid replacement and proper diet guidance. Besides conventional treatments, the treatment group administrated Zinc selenium Bao. Blood zinc and blood selenium values of two groups in the early treatment, the levels of serum immunoglobulin IgA, IgG,IgM and T cell subsets before and after treatment were respectively measured. Clinical efficacy was observed and the frequency of diarrhea relapse was recorded. Results Average blood zinc values ( t was 4.28 and 4.47 respectively, P ＜ 0.05 ) and average blood selenium ( t was 2.46 and 2.76 respectively, P ＜ 0.05 ) in two groups in the early treatment were significantly lower than those of healthy children.Before treatment the differences in the levels of IgA, IgG, IgM, CD3, CD4, CD8 and CD4/CD8 in two groups were not significant ( P ＞ 0.05 ). After treatment and 3-6 months of follow-up, the levels of IgA, IgG, CD3, CD4 and CD4/CD8 in the treatment group were significantly higher than those in the control group ( t was 10.76, 5.19, 3.86, 2.63 and 3.47 respectively, P ＜ 0.05 ). The clinical relief time and the total course of treatment in the treatment group were shorter than those in the control group ( t was 9.25 and 6.53 respectively,P ＜ 0.05 ). The total effective rates of treatment group and control group were 86.67％ and 66.67％, respectively, and the difference was significant (x2 was 5.03, P ＜ 0.05 ). The frequency of diarrhea episodes in the treatment group at different times within one year was significantly lower than that in the control group ( t was 10. 91, 4. 65 and 3. 72 respectively, P ＜ 0. 05 ). Conclusion Based on conventional treatment, giving zinc and selenium auxiliary treatment to children with persistent or chronic diarrhea has satisfactory efficacy in shortening course of disease, relieving symptoms, enhancing immune function of children, reducing relapse and improving long-term efficacy.